横浜市立大学大学院医学研究科顎顔面口腔機能制御学(口腔外科学)講座Department of Oral and Maxillofacial Surgery, Yokohama City University school of medicine

抄録

Wegener's granulomatosis (WG) is a systemic disease characterized by necrotizing granulomatous inflammation of the respiratory tract, kidneys, and other organs. The most characteristic oral manifestation of WG is an unusual form of hyperplastic gingivitis. Because the clinical appearance of the affected gums resembles overripe strawberries, the gingivitis is referred to as "strawberry gums". We report a case of WG showing typical strawberry gums with middle ear and nasal involvement. A 43-year-old woman was referred to our department because of gingival swelling after an operation for otitis media, which had not been diagnosed as WG at that time. The gingival surface appeared granular, resembling over-ripe strawberries. A gingival biopsy specimen showed microabscesses and multinucleate giant cells, characteristic findings of strawberry gums. The clinical appearance and histopathological findings suggested a diagnosis of WG. The diagnosis was supported by a positive anti-neutrophil cytoplasmic antibody test (cANCA). The patient responded to treatment with steroids and immunosuppressants, and the strawberry gums disappeared. The typical findings of strawberry gums were the initial diagnostic sign of WG.